Key Summary Points
- 1VATS is considered less invasive than open thoracotomy, but the incidence of CPSP is comparable, which attracted our attention.
- 2Previous studies suggested that intravenous (IV) S-ketamine was effective for decreasing the intensity of acute postoperative pain and opioid requirements. However, the efficacy of IV S-ketamine for CPSP in patients undergoing VATS remains uncertain.
- 3This study was conducted to determine whether preoperative intravenous S-ketamine is effective for CPSP after VATS.
- 4This study found that a single dose of preoperative S-ketamine in patients who underwent VATS had no significant impact on acute and chronic pain, or the consumption of analgesics after surgery. In the future, more studies are still needed to assess the effectiveness and safety of S-ketamine using different administration regimens to control pain after VATS.
To evaluate the efficacy of a single preoperative dose of S-ketamine for chronic post-surgical pain (CPSP) in patients undergoing video-assisted thoracoscopic surgical lung lesion resection (VATS).
A prospective randomized double-blind controlled study.
Patients were enrolled from March 17, 2021 to November 18, 2021 at a single tertiary academic hospital.
Patients were 18-65 years of age and undergoing VATS.
The experiment was divided into S-ketamine group (0.5 mg/kg intravenous injection before anesthesia induction) or placebo group (the same volume of normal saline).
Measurements and Main Results
The primary end point was the incidence of CPSP and its neuropathic component. The secondary end points included acute postoperative pain, the use of postoperative analgesics, anxiety and sleep quality scores, and the occurrence of adverse effects. There was no significant difference between the two groups in the incidence of CPSP, neuropathic pain, acute postoperative pain and postoperative use of analgesics. The sleep quality scores on the first postoperative day differed significantly between the groups (47.45 ± 27.58 vs. 52.97 ± 27.57, P = 0.049), but not the anxiety scores. In addition, the occurrence of adverse effects was similar between the two groups.
A single preoperative dose of S-ketamine in patients who underwent VATS had no significant impact on acute and chronic postoperative pain, as well the consumption of analgesics after surgery. A single preoperative dose of S-ketamine could improve the sleep on the first day after surgery, whereas it had no significant impact on anxiety level.
Registered in the Chinese Clinical Trial Registry (ChiCTR2100042140) on January 14th 2021.
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